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Pitcher’s Treatment Draws Scrutiny

Dr. Joseph R. Purita said he used Bartolo Colon's stem cells to help repair Colon's ligament damage and a torn rotator cuff.Credit
Marc Serota for The New York Times

BOCA RATON, Fla. — A year ago, Bartolo Colon, once one of major league baseball’s more durable starting pitchers, looked close to the end of the line: he had struggled with injuries after 2005, and elbow surgery had kept him out of baseball for the entire 2010 season.

The Yankees signed Colon in January after he pitched during the off-season in the Dominican Republic. His fastball — often registering at 93 miles per hour or better — appeared to be back. The 37-year-old Colon has gone 2-1, with an earned run average of 3.81, since being inserted into the club’s starting rotation.

A doctor in Florida would like to take some of the credit. Joseph R. Purita, an orthopedic surgeon who runs a regenerative medicine clinic in Boca Raton, said he and a team of Dominican doctors that he led treated Colon in April 2010. Purita said he employed what he regards as one of his more pioneering techniques: he used fat and bone marrow stem cells from Colon, injecting them back into Colon’s elbow and shoulder to help repair ligament damage and a torn rotator cuff.

Purita said he flew to the Dominican Republic and performed the procedures for free, doing it at the behest of a medical technology company based in Massachusetts that he has done business with for several years. Purita, who has used human growth hormone in such treatments, said in an interview that that he had not done so in Colon’s case. The use of human growth hormone is banned by baseball.

“This is not hocus-pocus,” Purita said in an interview here. “This is the future of sports medicine, in particular. Here it is that I got a guy back playing baseball and throwing pitches at 95 miles an hour.”

Purita said that he has treated at least two dozen professional athletes over the years, mostly baseball and football players, and that he has never given any of them H.G.H.

“I just won’t give it to these guys,” Purita said. “I don’t need the stigma and that kind of reputation.”

For the last few years, baseball and other sports, while fighting to limit the use of performance-enhancing drugs, have been faced with a new and murky challenge: players getting sophisticated blood treatments, often from doctors whose practices involve the regular use of H.G.H.

Brian Cashman, the Yankees’ general manager, said Wednesday that he had not known of Colon’s medical treatment when the club signed him. Cashman said Colon’s agent, aware that The New York Times was working on an article about the procedure and Purita’s role, had notified him recently of the procedure.

Cashman said he had, in response, informed Major League Baseball.

“The Yankees did notify us and we are looking into it,” said Pat Courtney, a spokesman for Major League Baseball.

Photo

Bartolo Colon, with a 2-1 record and a 3.81 E.R.A., has been a pleasant surprise so far this season for the Yankees.Credit
Barton Silverman/The New York Times

In October, a federal grand jury in Buffalo indicted Anthony Galea, a Canadian doctor, on charges that he provided many of the professional athletes he treated between July 2007 and September 2009 with human growth hormone and unapproved drugs. Galea was unlicensed to practice in the United States and yet had developed a reputation for helping athletes recover from injuries by using a blood-spinning technique known as platelet-rich plasma therapy. The athletes he treated included Alex Rodriguez, Tiger Woods, Jose Reyes, Carlos Beltran and the Olympic swimmer Dara Torres.

Those athletes have denied receiving H.G.H. Galea has acknowledged using H.G.H. himself but has denied providing any performance-enhancing drugs to professional athletes.

Purita, 61, graduated from Georgetown University Medical School. His clinic here offers the use of stem cells and platelet-rich plasma therapy, or P.R.P., as an alternative to surgery or in combination with it.

Purita uses P.R.P. injections with H.G.H. to treat many ligament, tendinitis and arthritic conditions, as well as muscle injuries and torn rotator cuffs. He said that P.R.P. and H.G.H. are both effective in supplementing stem cell therapy in certain individuals.

Purita said he has treated athletes with the Baltimore Ravens, the Miami Dolphins, the Chicago White Sox and the Texas Rangers in recent years.

About 14 months ago, Purita said, Harvest Technologies Corp., a Massachusetts company that has done work in the adult stem cell field, contacted him. Purita said the company told him that a doctor in the Dominican Republic, Leonel Liriano, was looking to get Colon treated.

Colon, who has twice won 20 games in a season in his career, had struggled with injuries after winning the 2005 American League Cy Young award. In the next four seasons, he made only 48 appearances with three different teams. An elbow injury sidelined him for the final two months of the 2009 season, and he did not play at all in the majors in 2010.

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Purita said he agreed to go to the Dominican Republic to work with Liriano and treat Colon.

“It was not that it was illegal to do the procedure here in the United States,” Purita said. “He was just living in the Dominican Republic. Everything was above board.

“Colon said he wanted to get back into baseball,” Purita recalled. “He could not throw the ball without horrible pain, but he felt he still had something left in the can, so to speak. I told Colon this will be a lot less painful than facing Derek Jeter. He said: ‘Derek Jeter? He has never been a problem for me. I always strike him out.’ ”

Liriano, a physician at Clinica Union Medica in the city of Santiago, where the procedure was done, said a cardiologist, a general surgeon, an anesthesiologist and an orthopedic surgeon were also present for the treatment.

“He showed us how to do the procedure,” Liriano said of Purita. “This was the highest-profile athlete I had worked on. I had done some Dominican basketball players before that.”

Photo

Dr. Joseph R. Purita said he led a medical team in the Dominican Republic that worked on Bartolo Colon. Credit
NYTCREDIT: Marc Serota for The New York Times

Some experts in the field were cautious in assessing the efficacy of such stem cell treatment.

Dr. Freddie H. Fu, chairman of the department of orthopedic surgery at the University of Pittsburgh School of Medicine and the University of Pittsburgh Medical Center, said, “Bone marrow is a good source of stem cells, but I don’t think there is any definitive evidence to show that it will benefit a condition like this.”

Fu added: “You need more of a scientific study. Just the use of this generally should not be done because it is not shown to be effective. In this case, we don’t know how the body’s natural healing abilities, along with the player’s own training, influenced the outcome. We know how stem cells work in cancer and AIDS patients. But in sports, we just don’t know. There is a lot of hype.”

Purita said that once the procedure was done — it lasted roughly 45 minutes, he said — the results were evident.

“We had him start working out within the first month,” Purita said. “Then I am hearing that he is starting to pitch, and then I hear that he is starting to tear them up in the Dominican league. But I said with a rotator cuff tear and a bad elbow, I don’t know about him getting back into the majors.”

Colon was pitching for a Dominican winter ball team managed by Tony Pena, the longtime Yankee coach. Eventually, the Yankees signed him to a contract for $900,000, a relative bargain.

Once the season started, Colon’s role grew in importance. He has taken Phil Hughes’s spot in the rotation, and been a considerable surprise. He is scheduled to start Friday night’s game against the Red Sox at Yankee Stadium.

Colon, whose English is limited, answered only, “I don’t know, I don’t know,” in Spanish when asked last week about his medical treatment in the Dominican Republic. He was not available in the team’s clubhouse Wednesday evening.

“I feel in my heart and my soul, his performance has been because of the treatment,” Liriano said. “You see that his fastball is about 95 or 96 miles per hour. It is a miracle, no?”

“This is not just about what we did,” he said. “We gave him the means, but he has the focus and desire, the killer instinct. He worked his tail off to get back in the game. That is something stem cells cannot fix.”

Colon’s agent, Mitch Frankel, agreed. “The doctor feels that it definitely gave him a jump start to his improvement, although for me, personally, I don’t think Bartolo was focused on baseball mentally or physically for the last few years,” Frankel said. “I believe the problem was that and not his pitching. And I think once he made that determination, you can see the success.”

Still, Liriano said he was hopeful he could persuade the retired Pedro Martinez to undergo the treatment and consider a return.

“I have not gotten any response yet,” Liriano said. “We are focusing on high-profile athletes whose best years are gone.”

Correction: May 12, 2011

An earlier version of this article and a caption with a photo incorrectly stated Bartolo Colon's Win-Loss record. He is 2-1, not 2-0.